Summary Of Benefits.pdf

2023_WPE_Local_Health_Plan_SBC.pdf
Preview of Summary of Benefits
🔗 Source: ghcscw.com
📊 Size: 538 KB
👤 Author: CMS
⬇️ Downloads: 43

Summary

$250 individual/$500 family deductible, preventive care and primary care services covered before deductible, $1,250 individual/$2,500 family medical out-of-pocket limit, $600 individual/$1,200 family prescription drug out-of-pocket limit, referrals required to see specialists, network providers cost less, copayments and coinsurance apply to various services, out-of-network providers not covered or cost more.

Description

$250 individual/$500 family deductible, preventive care and primary care services covered before deductible, $1,250 individual/$2,500 family medical...

Technical Information

  • File Format: PDF
  • File Size: 538 KB
  • Pages: 8
  • Language: EN
  • Author: CMS
  • Total Downloads: 43
  • Last Updated: 1 week ago

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